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The Heart Historian

The Heart Historian

Ari Cedars knew studying history was in his future — but he didn’t know it would be history related to the mysteries of congenital heart disease.

Growing up, Ari Cedars loved history. Indeed, when he arrived as a freshman at the University of Texas (UT) at Austin, there was no question history would be his major. However, his own family history of doctors, including his grandfather, father, and aunts and uncles, was on his mind. And so was his self-described “knack for science.”

“I ended up going into medicine, but I liked history, too,” Cedars says. “Maybe that’s why I went into congenital heart disease. All of these patients have such long histories.”

He began to discover this after his first year of medical school at UT, in the research lab of Heinrich Taegtmeye, a pioneer in cardiac metabolism. Next, Cedars was influenced by Philip Ludbrook, a mentor and head of the adult congenital heart disease program at Washington University in St. Louis. There, and at UT Southwestern in Dallas, Cedars learned how to manage not only patients but also an entire congenital heart program for adults. That led to his recruitment to fill a need at the Blalock-Taussig-Thomas Pediatric and Congenital Heart Center at Johns Hopkins.

“As in many institutions, adults with congenital heart problems were either being seen on the pediatric or adult side,” says Cedars. “They wanted a program that combined pediatric and adult cardiology in transitioning these patients to young adults.”

Cedars, who has training and experience in both worlds, says the transition is critically important. While pediatric cardiologists have a deep understanding of the anatomy of a child with congenital heart disease, events such as pregnancy are uncommon among their patients — as is acquired coronary vascular disease. General adult cardiologists, on the other hand, are well aware of how such adult conditions affect the heart, but they have limited training in congenital heart defects and are generally unfamiliar with the ways that early repairs deteriorate over time.

“It’s important to have someone who can provide care for both congenital heart disease and adult related problems, and who knows the ways in which those two worlds will interact with one another in the same patient,” says Cedars.

He firmly believes this blended experience, along with adult hospital services like Gyn/Ob and maternal-fetal medicine, are the way to go in caring for adults with congenital heart disease.

“I think having a single center under one roof for pediatric and adult care is a huge advantage,” says Cedars. “Providing adult congenital heart disease care solely in a pediatric or adult program leads to difficulties in access to unique care needs.”

Treating congenital heart disease in a strong research-minded institution doesn’t hurt either, says Cedars. His current research goal is to quantify the impact of therapeutic interventions on patients’ lives between hospitalizations and office visits. Are patients improving or declining?

“This is a major component of what’s been missing in clinical trials in almost all fields of cardiology — the bulk of information that can be gleaned from patients through their day-in day-out experiences to see if our interventions are helping them,” says Cedars.

His research tools include patients’ self-reported outcome metrics and a patient-centered health care app to store them.

“That way I can be in my patients’ pocket experiencing life as they experience it and have the data in a quantifiable format,” says Cedars.

Does he have any regrets about not becoming an historian?

“That human being I end up taking care of has a long history of disease and procedures that leads to the way they are now,” says Cedars. “You could call me a heart historian.”

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